Surprising findings about overnight ER

St. Marys Journal Argus

Four months after the return of 24-hour Emergency Room services at Seaforth General Hospital, an informal analysis reveals an increase in usage during the overnight time period, compared to the three months previous to cutting back hours.

Meanwhile, among the three smaller hospitals within the Huron Perth Healthcare Alliance (HPHA), it&rsquo;s Clinton &mdash; rather than the previously-troubled Seaforth and St. Marys &mdash; which is currently facing the biggest challenge securing staff to maintain overnight, summertime ER coverage.

In Seaforth, a report from the hospital&rsquo;s chief of staff explains the number of night-time ER visits was &ldquo;comparable&rdquo; between February-April, 2008, versus the (From Page 1)

same months in 2011. But &ldquo;there was an 87 per cent increase in (patients assessed as) triage level 2, and a 27 per cent increase in triage 3. This indicates we are seeing much sicker people, those who need to come in, during that time&rdquo;, in 2011 compared to 2008.

&ldquo;I am happy to report that everyone is aware and taking full advantage of the 24-hour coverage,&rdquo; concluded the May 2 report to the HPHA board of directors from Seaforth Chief of Staff, Dr. Heather Percival.

Seaforth&rsquo;s ER hours were shortened for several months due to an inability to fill overnight nursing staff shifts. It reopened on a full-time basis earlier this year.

Administrators at St. Marys Memorial Hospital, meanwhile, have struggled during recent summers to fill all physician shifts in the ER. This is not the case this year: in his report to the June 2 HPHA meeting, St. Marys Chief of Staff Dr. Chuck Gatfield explained &ldquo;we are better at present than any time in the last five years, as far as summer scheduling is concerned,&rdquo; with just three shifts in August yet to confirm.

ER departments in both St. Marys and Seaforth are threatened with nightly closure in the HPHA&rsquo;s &ldquo;Vision 2013&rdquo; planning document. &ldquo;Vision 2013&rdquo; has been approved by the agency which allocates funding to the HPHA, but changes to ER services are on hold until the release of a report from a Health Ministry task force into the issue.

Speaking to the HPHA board of directors, Dr. Percival suggested the increase in triage 2 and 3 patients during February-April in the newly-reopened Seaforth night-time ER &ldquo;may just be a blip.&rdquo; But she noted &ldquo;it has been a lot of work . . . through the night, when we were counting on it being a little quieter.&rdquo;

&ldquo;It is something to keep an eye on for staffing of both physicians and nurses,&rdquo; the Seaforth chief of staff wrote in her report.

In Clinton, administrators aren&rsquo;t just keeping an eye on staffing for the future. That hospital, according to a different report to the May 2 HPHA meeting, faces major staffing challenges now.

Shirley Veenendaal, who has been spearheading the HPHA&rsquo;s discussions with an agency called South West Health Force Ontario &mdash; which determines when hospitals are eligible for emergency government-funded support &mdash; explained the Clinton situation at the May 2 meeting.

&ldquo;We had a great number of shifts that were requiring coverage in June, July and August,&rdquo; Veenendaal reported.

Earlier this year, an application from Clinton was turned down by Health Force Ontario. Another application was filed, however, and Veenendaal told the HPHA board members that support from the agency was subsequently approved for the time period May 1 to Oct. 31, 2011. So she expects solutions will be found for those shifts not yet covered.

A frank warning was, however, contained the Clinton site chief&rsquo;s report to the May 2 meeting: &ldquo;all of us who are doing Emergency work in Clinton on a regular basis are getting older and we are reaching the limit of what we can accomplish,&rdquo; wrote Dr. Maarten Bokhout. &ldquo;We do not intend to withdraw services but there is a limit to how much service we can provide.&rdquo;